[Insertion of Judet's prosthesis in high-region dislocation of the hip (author's transl)].

Osteoarthrosis of the hip (also known as coxarthrosis) as a result of a high-region dislocation of the hip, presents a difficult task for the orthopaedic surgeon, the solution of which is still under frequent and intense discussion. Total hip replacemnt (hip endoprosthesis) involves technical difficulties which result on the one hand, from the underdeveloped anatomic conditions (underdeveloped primary acetabulum with soft spongiosa on valgus position of the highly sclerosed secondary acetabulum associated with underdeveloped shaft of the femur); on the other hand, a repositioning is difficult if anchoring of the prosthesis is effected at the level of the primary acetabulum. For this reason, we developed an original operation method requiring two sessions: in a first operation, an extended arthrolysis is performed via an anterior access, whereas at the same time an extension is carried out by means of the distraction apparatus according to Wagner. After this first session, distraction is performed during 3 to 4 weeks until the head of the femur has attained the level of the primary acetabulum. The prosthesis is inserted in a second session, where anchoring at the level of the primary acetabulum becomes possible and repositioning can be affected without undue difficulties. An example of such total hip replacement by endoprosthesis, requiring 2 sessions, is demonstrated.